Benzodiazepine prescriptions for veterans with PTSD declined over 10-year period

Benzodiazepine prescriptions for U.S. military veterans with PTSD declined due to decreased prevalence over a 10-year period, according to a retrospective observational study published in the Journal of Clinical Psychiatry.

“Given concerns about inappropriate prescribing in post-9/11 veterans, a particular emphasis for [the Veterans Health Administration] has centered on developing innovative strategies to deprescribe off-label medications,” Nancy C. Bernardy, PhD, of the department of psychiatry at Geisel School of Medicine at Dartmouth, and colleagues wrote.

Researchers sought to identify benzodiazepine prescription changes for U.S. military veterans with PTSD, to spearhead future endeavors in halting potentially harmful prescribing practices. The study utilized Veterans Health Administration databases between 2009 and 2019 to examine prevalence and incidence of benzodiazepine prescriptions for veterans with PTSD, according to ICD-9/10 criteria.

Results showed a sharp decline in prevalence of benzodiazepines, from 31.3% in 2009 to 10.7% in 2019, with incidence also sharply declining, from 11.4% to 2.9%, in that same timeframe, as well as a 30% decrease in daily benzodiazepine dosage.

Data additionally revealed an increase in rate of drug discontinuation accounted for a 21% drop in prevalence, as incidence among patients with PTSD subsided by 36.8% and new patients with PTSD accounted for a 42.2% drop.

Bernardy and colleagues also found that women were prescribed benzodiazepine more often than men (OR = 1.67; 95% CI, 1.64-1.70), and the proportion of older adults provided the drug increased for both existing (14.5% in 2009, 46.5% in 2019) and new (8.6%, 24.3%) recipients.

“Our inquiry supports the effectiveness of national VA educational initiatives put into place to improve benzodiazepine prescribing practices,” Bernardy and colleagues wrote. “We believe these strategies offer not only lessons, but resources to other health care systems, providers and patients to reduce inappropriate benzodiazepine prescribing and other potentially harmful practices.”